ALTERNATE ROUTE:“We’re seeing more promotional dollars going to non-CME product talks on our exhibit floor,” said Cathy Scheck, vice president of education and meetings for the Heart Rhythm Society. “It’s not accredited CME, and it’s clearly noted that it’s not CME, but they have been very well attended.”

one commercial supporter for an evening program or a break- fast meeting. Now, even for that, we have to reach out to mul- tiple commercial supporters.” And while most of the large pharmaceutical and device

a literature review; it’s interviewing key opinion leaders and establishing the true need for the program. You didn’t used to spend hours doing research to justify the program, and now that’s a requirement.” Even at MECCs, which typically have more staff dedicated

to grant proposals than smaller medical associations and soci- eties, are feeling the strain of the new requirements, according to Sullivan. “To write a good grant,” he said, “you have to have a very robust needs assessment. You have to include out- comes and whether or not it helped change what the physi- cians believe or what they practice. It takes a lot of time and staff effort.” Because the purse strings have tightened,CME providers

aren’t likely to receive full funding froma single proposal. That means meetings and education staff must repeat the arduous proposal process multiple times for a single event. “For just one program, we submit 10 different proposals,” said Cathy Scheck, vice president of education and meetings for the Heart Rhythm Society (HRS). “In a year, we probably submit 35 to 50.” Hathaway Stella added: “We used to get

TIMELINE: INDUSTRY-BACKED CME 2007

TheU.S.Senate Finance Committee releases a staff report, the culmination of a two-year investigation, claiming that there is evidence that drug and medical-device companies use edu- cational grants as a way to increase market share, and that some CME programs are improperly influenced by commer- cial sponsors.

companies have an online grant-submission process, that doesn’t make the task any easier. There’s no universal application form, so every proposal must be customized. “It is onerous, because each company has a different process

“It is onerous ... each company has a different process and a different schedule.”

and a different schedule,” Scheck said. “A big part of our job is just keeping up with the various schedules.” To help manage the increasingly complicated grants process,

a number ofCMEproviders are staffing up. At ISDA, Harwood is looking to bring on a full-time staff person. At the American Society of Anesthesiologists, Chief Learning Officer Diane Gam- bill doesn’t rely on grants. But in her previous life, she was chief scientific officer for a MECC, where she expanded her staff of